Provider Demographics
NPI:1659130417
Name:QUINTON, SUSAN ARMINDA (OD)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:ARMINDA
Last Name:QUINTON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 S MISSION RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:ROSSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30741-2404
Mailing Address - Country:US
Mailing Address - Phone:423-619-9818
Mailing Address - Fax:
Practice Address - Street 1:1895 BATTLEFIELD PKWY
Practice Address - Street 2:
Practice Address - City:FT OGLETHORPE
Practice Address - State:GA
Practice Address - Zip Code:30742-4021
Practice Address - Country:US
Practice Address - Phone:706-861-7166
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-15
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1404152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist